Risk factors for short-term outcomes after thoracoscopic lobectomy for lung cancer
Risk factors for short-term outcomes after thoracoscopic lobectomy for lung cancer
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DOI：
10.1183/13993003.01939-2015
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发表时间：
2016-08-01
影响因子：
24.3
通讯作者：
Hyodo, Masahiro
中科院分区：
文献类型：
--
作者：
Irie, Masataka;Nakanishi, Ryoichi;Hyodo, Masahiro
很少有研究分析了接受胸腔镜肺叶切除术患者的术后风险因素，包括术前身体功能评估。本研究的目的是确定预测术后恶化的性能状态和心肺并发症的情况下，胸腔镜肺叶切除术，2005年6月至2012年10月，我们回顾性分析了188例连续的主题谁接受了胸腔镜肺叶切除术的术前I期非小细胞肺癌。人口统计学和临床参数，包括身体功能，进行了分析，使用多变量logistic回归，以澄清的determinations.The预测的一氧化碳，股四头肌肌力和病理阶段的肺弥散量的百分比是独立的危险因素，手术后的性能状态恶化的多变量分析。慢性阻塞性肺疾病、6分钟步行距离和病理分期也是术后心肺并发症的独立危险因素，我们的数据表明，除了病理分期较高、弥散功能较低和合并慢性阻塞性肺疾病外，身体功能较差与胸腔镜肺叶切除术后的短期预后较差相关。术前股四头肌肌力和6分钟步行试验的评估很容易进行，因此可能是一个有用的预测胸腔镜肺叶切除术的情况下。
Few studies have analysed postoperative risk factors in patients undergoing thoracoscopic lobectomy, including assessments of preoperative physical function. The objectives of this study were to identify predictors of postoperative deterioration of performance status and cardiopulmonary complications in cases of thoracoscopic lobectomy.Between June 2005 and October 2012, we retrospectively reviewed 188 consecutive subjects who underwent thoracoscopic lobectomy for preoperative stage I nonsmall cell lung cancer. The demographic and clinical parameters, including physical function, were analysed using a multivariate logistic regression to clarify the determinants.The percent predicted diffusing capacity of the lung for carbon monoxide, quadriceps muscle strength and pathologic stage were independent risk factors for deterioration of performance status after surgery in the multivariate analyses. Chronic obstructive pulmonary disease, 6-min walking distance and pathologic stage were also independent risk factors for postoperative cardiopulmonary complications.Our data suggest that, in addition to a greater pathologic stage, lower diffusing capacity and comorbid chronic obstructive pulmonary disease, poor physical function was associated with worse short-term outcomes after thoracoscopic lobectomy. An evaluation of preoperative quadriceps muscle strength and 6-min walk test is easily performed and may therefore be a useful predictor in cases of thoracoscopic lobectomy.